| 1. |
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| 2. |
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| 3. |
- Aspevall, O, et al.
(författare)
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Performance of four chromogenic urine culture media after one or two days of incubation compared with reference media.
- 2002
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Ingår i: Journal of Clinical Microbiology. - 0095-1137 .- 1098-660X. ; 40, s. 1500-1503
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Tidskriftsartikel (refereegranskat)abstract
- Four chromogenic urine culture media were compared to culture on blood agar, MacConkey agar, and CLED (cysteine-, lactose-, and electrolyte-deficient) agar for detection of uropathogens in 1,200 urine specimens. After 2 nights of incubation, 96% of all isolates were recovered on blood agar, 96% were recovered on CLED agar, 92% were recovered on CPS ID2, 96% were recovered on CHROMagar Orientation from BBL, 95% were recovered on CHROMagar Orientation from The CHROMagar Company, and 95% were recovered on Chromogenic UTI Medium.
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| 4. |
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| 5. |
- Ekerfelt, Christina, 1957-, et al.
(författare)
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Lyme borreliosis in Sweden - Diagnostic performance of five commercial Borrelia serology kits using sera from well-defined patient groups
- 2004
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : Wiley. - 0903-4641 .- 1600-0463. ; 112:1, s. 74-78
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Tidskriftsartikel (refereegranskat)abstract
- Five commercial Borrelia serology kits available in Sweden were evaluated and compared for their diagnostic performance in sera from clinically well-characterized patient groups. With the clinically defined groups as the gold standard, i.e. without knowledge of antibody status in serum and cerebrospinal fluid, the diagnostic performance of the kits was compared and important differences in diagnostic usefulness were found. The kits from Abbot and DAKO, that often predict clinically relevant Borrelia infection and do not detect antibodies in sera from patients without strong suspicion of Borrelia infection, were considered the most useful in the population studied. This kind of validation study is an important part of good laboratory practice and should be performed by laboratories serving patient populations with varying endemicity of Borrelia.
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| 6. |
- Eriksson, Katarina, et al.
(författare)
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A double-blind treatment study of bacterial vaginosis with normal vaginal lactobacilli after an open treatment with vaginal clindamycin ovules
- 2005
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 85:1, s. 42-46
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Tidskriftsartikel (refereegranskat)abstract
- The expected 4-week cure rate after conventional treatment of bacterial vaginosis are only 65-70%. In an attempt to improve the cure rate by adding probiotic lactobacilli we performed a double-blind placebo-controlled study of adjuvant lactobacilli treatment after an open treatment with vaginal clindamycin ovules. Women with bacterial vaginosis as defined by Amsel's criteria were treated with clindamycin ovules. Vaginal smears were collected and analysed according to Nugent's criteria. During the following menstruation period the women used, as an adjuvant treatment, either lactobacilli-prepared tampons or placebo tampons. The lactobacilli tampons were loaded with a mixture of freeze-dried L. fermentum, L. casei var. rhamnosus and L. gasseri. The cure rate was recorded after the second menstruation period. There was no improvement in the cure rate after treatment with lactobacilli-containing tampons compared to placebo tampons, the cure rates as defined by Amsel's criteria were 56% and 62%, respectively, and 55% and 63%, as defined by Nugent's criteria. This is the first study to report cure rates for women with 'intermediate' wet smear ratings according to Nugent's classification and this group had an overall cure rate of 44%. The cure rate of treatment of bacterial vaginosis was not improved by using lactobacilli-prepared tampons for one menstruation.
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| 7. |
- Eriksson, K., et al.
(författare)
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Validation of the use of Pap-stained vaginal smears for diagnosis of bacterial vaginosis
- 2007
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Ingår i: APMIS : acta pathologica, microbiologica, et immunologica Scandinavica. - : Wiley. - 1600-0463 .- 0903-4641. ; 115:7, s. 809-813
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Tidskriftsartikel (refereegranskat)abstract
- Papanicolaou-stained cervicovaginal smears (Pap smears) are used to screen for cervical cancer. Since there is a lack of consensus in published reports respecting the efficacy of Pap-stained smears in BV diagnostics, there is a need to validate their use for diagnosis of BV. Slides from the international BV00 workshop were Pap stained and independently analyzed by four investigators under a phase-contrast microscope. All workshop slides-whether Pap-stained, Gram-stained or rehydrated air-dried smears-were scored according to the same Nugent classification. The diagnostic accuracy of Pap smears for diagnosis of BV had a sensitivity of 0.85 and a specificity of 0.92, with a positive and negative predictive value of 0.84 and 0.93, respectively. The interobserver weighted kappa index was 0.86 for Pap-stained smears compared to 0.81 for Gram-stained smears, and 0.70 for rehydrated air-dried smears using the mean Nugent score as the criterion standard. Provided that the samples are taken from equivalent locations (the vaginal fornix) and analyzed according to the same scoring criteria, there is no discernable difference in the diagnostic accuracy of the three smear-staining methods. The Pap-stained vaginal smears can be used as a wholly adequate alternative to Gram-stained smears for BV diagnosis.
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| 8. |
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| 9. |
- Forsum, Urban, 1946-, et al.
(författare)
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Bacterial vaginosis--a microbiological and immunological enigma.
- 2005
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Ingår i: APMIS : acta pathologica, microbiologica, et immunologica Scandinavica. - : Wiley. - 0903-4641 .- 1600-0463. ; 113:2, s. 81-90
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Tidskriftsartikel (refereegranskat)abstract
- The development of bacterial vaginosis (BV) among women of childbearing age and the resulting quantitative and qualitative shift from normally occurring lactobacilli in the vagina to a mixture of mainly anaerobic bacteria is a microbiological and immunological enigma that so far has precluded the formulation of a unifying generally accepted theory on the aetiology and clinical course of BV. This critical review highlights some of the more important aspects of BV research that could help in formulating new basic ideas respecting the biology of BV, not least the importance of the interleukin mediators of local inflammatory responses and the bacterial shift from the normally occurring lactobacilli species: L. crispatus, L. gasseri, L. jensenii, and L. iners to a mixed flora dominated by anaerobic bacteria.
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| 10. |
- Forsum, Urban, 1946-, et al.
(författare)
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Bakteriell vaginos
- 2004
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Bok (övrigt vetenskapligt/konstnärligt)
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| 11. |
- Forsum, Urban, 1946-, et al.
(författare)
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Begrepp och termer inom hälso- och sjukvård
- 1999
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Ingår i: Socialmedicinsk tidskrift. - Stockholm : Socialmedicinsk tidskrift. - 0037-833X. ; :6, s. 540-547
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Tidskriftsartikel (refereegranskat)
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| 12. |
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| 13. |
- Forsum, Urban, 1946-, et al.
(författare)
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Developments in the recent past - Immunology
- 2007
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : Wiley-Blackwell Publishing Inc.. - 0903-4641 .- 1600-0463. ; 115:5, s. 406-408
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 14. |
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| 15. |
- Forsum, Urban, 1946-
(författare)
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Ett område där värderingarna går isär
- 2008
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 105:43, s. 3058-3058
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Tidskriftsartikel (refereegranskat)
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| 16. |
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| 17. |
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| 18. |
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| 19. |
- Forsum, Urban, 1946-, et al.
(författare)
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Literary fiction in the medical programme
- 2006
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Ingår i: Celebrating the past by expanding the future.. - : Lecture Notes in Computer Science. - 9185643076 ; , s. 38-40
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- During the fall of 2006, the Faculty of Health Sciences (FHS) celebrates its 20th birthday. Linköping has a long tradition of health education; our nursing programme started already in 1895 and occupational therapy began in 1965. From the late 1960’s, medical students from Uppsala spent their last seven semesters in Linköping, mainly for clinical studies. After some years, academic and teachers from the young faculty, together with the county council, realized the enormous potential benefits of a complete undergraduate medical programme at Linköping University. Inspired by apparent innovations from McMaster University in Canada, Maastricht in Holland, Ben Gurion in Israel and Tromsø in Norway, these ideas and ideals were gradually turned into reality. In a complicated process, concerning the life or death of the medical faculty, a close co-operation between the University and the County Council of Östergötland was extremely fruitful. A proposal regarding a complete medical programme, and study periods integrated between the other health education programmes, was forwarded to the Swedish government in December 1982 and approved in 1984.
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| 20. |
- Forsum, Urban, 1946-, et al.
(författare)
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Methods in molecular biology
- 2004
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- An accessible introduction to how genomics has and will provide novel methods for bacterial investigation and advance our understanding and knowledge of bacterial pathogenicity. The authors critically evaluate the applications of genomics to diagnostic bacteriology, highlighting both current and likely future uses, describing real-time PCR methods, and outlining the promise of microarrays in clinical bacteriology. Their discussion examines in detail genomic approaches to antibacterial discovery, the nature of pathogenicity, the discovery of new pathogens, the exploration of the concept of clonality in bacteria, and bacterial taxonomics.
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| 21. |
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| 22. |
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| 23. |
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| 24. |
- Forsum, Urban, 1946-, et al.
(författare)
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Special edition : Dendritic cells.
- 2003
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - 0903-4641 .- 1600-0463. ; 111, s. 673-674
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Tidskriftsartikel (refereegranskat)
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| 25. |
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| 26. |
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| 27. |
- Forsum, Urban, 1946-, et al.
(författare)
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The impact of qualitative analysis in laboratory medicine
- 2005
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Ingår i: TrAC. Trends in analytical chemistry. - : Elsevier BV. - 0165-9936 .- 1879-3142. ; 24:6, s. 546-555
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Tidskriftsartikel (refereegranskat)abstract
- Laboratory medicine is a challenge for the metrologically and terminologically inclined scientist. One main reason is the need for a sound theory that can be applied in a systematic way to cover all aspects of examinations, i.e., those procedures whose results are reported on an ordinal scale and those reported on more primitive scales (e.g., classifications and narratives). Validation of procedures for examinations involving properties on a nominal scale is especially difficult to achieve because it is hard to find gold standards, in the conventional sense, against which to validate and which combine performance characteristics and clinically relevant specificity and sensitivity. We present a systematic, unambiguously defined terminology (the C-NPU coding scheme) for metrologically derived terms for expressing properties, and present some examples of how to attain diagnostic goals. If the analytic process in the laboratory can be subsumed into medical contexts in a systematic way, many pitfalls in reporting results can be avoided. © 2005 Elsevier Ltd. All rights reserved.
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| 28. |
- Forsum, Urban, 1946-
(författare)
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Varning för Ellen!
- 2004
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 101:17, s. 1544-1544
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 29. |
- Jakobsson, Tell, 1951-, et al.
(författare)
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Changes in the predominant human Lactobacillus flora during in vitro fertilisation
- 2008
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Ingår i: Annals of Clinical Microbiology and Antimicrobials. - : BioMed Central (BMC). - 1476-0711. ; 7
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Signature matching of nucleotide sequences in the V1 and V3 regions 16S rRNA genes using pyrosequencing technology is a powerful tool for typing vaginal Lactobacilli to the species level and has been used for investigating the vaginal microbial niche. Methods: This study has characterized the normal cultivable vaginal Lactobacillus flora at varying estradiol levels in plasma, the study comprised 17 patients undergoing ovarian stimulation for In Vitro Fertilization (IVF) treatment. The vaginal status of each participant was initially assessed as normal according to Amsel and Nugent criteria. Results: L. crispatus, L. gasseri and/or L. jensenii were present in 10of the patients throughout the study period, and little variation among these three species was encountered in individual patients. The flora of three women was dominated by L. delbrüeckii, L. rhamnosus or L. vaginalis. One woman exhibited a dominance of L. iners. The flora of the remaining three women were initially dominated by L. rhamnosus or L. reuteri, but as their estrogen levels rose, their flora composition altered, to become dominated by one of the three species most common in a normal, healthy vagina. Conclusion: Signature matching of nucleotide sequences in the V1 and V3 regions of 16S rRNA genes is a discriminative tool for the study of vaginal Lactobacilli and can be used to track the Lactobacillus flora under a variety of physiological conditions. © 2008 Jakobsson and Forsum, licensee BioMed Central Ltd.
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| 30. |
- Jakobsson, Tell, 1951-, et al.
(författare)
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Vaginala laktobaciller som normalflora
- 2004
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Ingår i: Bakteriell Vaginos. - Växjö : Grafiska Punkten. - 9163148005 ; , s. 31-35
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 31. |
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| 32. |
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| 33. |
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| 34. |
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| 35. |
- Karlsson, Daniel, 1969-, et al.
(författare)
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Concepts, contexts and expert systemms
- 1999
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Ingår i: Medical Informatics Europe99,1999. - Amsterdam : IOS Press. ; , s. 713-
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Konferensbidrag (refereegranskat)
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| 36. |
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| 37. |
- Karlsson, Daniel, 1969-, et al.
(författare)
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Medical decision-support systems and the concept of context
- 2004
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Ingår i: Medical informatics and the Internet in medicine (Print). - : Informa UK Limited. - 1463-9238 .- 1464-5238. ; 29:2, s. 109-118
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Tidskriftsartikel (refereegranskat)abstract
- Medical decision-support systems are of necessity multi-contextual in nature. There are always at least two contexts involved in the use of such systems: the expert knowledge-provider context and the end-user context. To show this, we present examples of context-dependent aspects significant to the use of decision-support systems. The existence of discrepancies between the contexts threatens to disrupt the rationale for using decision-support systems: for the system to transfer knowledge from the expert to the end-user. Both theoretical and empirical studies show that such discrepancies exist and that they may be detrimental to the use of decision-support systems. Systems must thus give support in interpreting the output produced by the system in the context of the end-user. © 2004 Taylor and Francis Ltd.
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| 38. |
- Karlsson, Daniel, 1969-, et al.
(författare)
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Using the MEDLINE® database to study the concept of urinary tract infections in different domains of medicine
- 2004
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Ingår i: Upsala Journal of Medical Sciences. - 0300-9734 .- 2000-1967. ; 109:2, s. 141-157
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Tidskriftsartikel (refereegranskat)abstract
- As a way of exploring differences between medical domains regarding management of urinary tract infections, we investigated the MEDLINE® database for differences in indexing patterns. Further, our intention was to assess the MEDLINE® database as a source for studying medical domains. We examined the use of main headings, subheadings and the level of main headings in six medical domains that manage urinary tract infections. Many intuitive but also some counterintuitive results were found indicating that the MEDLINE® database is difficult to use for studying medical domains mainly due to unclear semantics both in the headings and the indexing process, which results in variability in indexing. This variability probably hides sig-nificant results. We also conclude that the differences found indicate that in addition to differences between domains, there are also large variations within domains.
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| 39. |
- Klingspor, Lena, et al.
(författare)
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A prospective epidemiological survey of candidaemia in Sweden
- 2004
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 36:1, s. 52-55
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Tidskriftsartikel (refereegranskat)abstract
- A prospective epidemiological survey of candidaemia was performed in central Sweden from January 1998 to December 1999. In total, 191 episodes were reported with an overall rate of 0.32/1000 admissions. Candida albicans was identified in 128 cases (67%), followed by Candida glabrata in 30 (15.7%) and Candida parapsilosis in 14 (7.3%). Predisposing factors included surgery (31.4%), intensive care (18.8%), solid tumour or haematological malignancy (15.7%), and foetal immaturity (15.7%). Now-albicans Candida species were more prevalent among patients with haematological malignancies (56%), compared to surgical (30%) and ICU patients (19%). The crude mortality rate of candidaemia was 31%. The highest mortality rate was observed in patients with haematological malignancies (41.2%), age > 70 y (41%), surgery (38.5%) and infections with > 1 Candida species (40%) or C. glabrata (38%).
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| 40. |
- Larsson, Marie, 1966-, et al.
(författare)
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Endocytosis of Potential Contact Sensitizers by Human Dendritic Cells
- 1993
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Ingår i: Dendritic Cells in Fundamental and Clinical Immunology. - New York : Plenum Publishing. - 9780306444074 - 9781461362722 - 9781461529309 ; , s. 593-597
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Several lines of evidence indicates that a population of lymphoid cells occurring in most organs of the body with a dendritic morphology is of prime importance in the initial stages of immune responses (1). Immunohistochemical distribution studies using various cell surfaces phenotypic markers has often been used to argue the probable importance of dendritic cells in tissues for the initial immune response (2,3). It has however proven difficult to compare these cells from all tissues functionally in vitro due to low yields and alteration of the phenotype when the cells are enzymatically dislodge from the tissues. Most studies have thus focused on the Langerhans cell of the skin, spleen dendritic cells and negatively selected dendritic cells from human peripheral blood.
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| 41. |
- Larsson, PG, et al.
(författare)
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Diagnostik. Diagnostikmetoder
- 2004
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Ingår i: Bakteriell Vaginos. - Växjö : Grafiska Punkten. - 9163148005 - 9789163148002 ; , s. 49-57
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 42. |
- Larsson, Per-Göran, 1953-, et al.
(författare)
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Late miscarriage and preterm birth after treatment with clindamycin : A randomised consent design study according to Zelen
- 2006
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 113:6, s. 629-637
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To screen for bacterial vaginosis (BV) and to investigate the effect of treatment with vaginal clindamycin in order to observe the effect on late miscarriage and delivery prior to 37 completed weeks (primary outcome). Design: Randomised consent design for clinical trials according to Zelen. Setting: Southeast region of Sweden. Population: A total of 9025 women were screened in early pregnancy. Methods: A total of 819 women with a Nugent score of 6 and above were considered to have BV and treated according to Zelen allocation. The incidence of late miscarriage and spontaneous (noniatrogenic) preterm birth was assessed. Main outcome measures: Late miscarriage and spontaneous preterm delivery before 37 weeks. Results: Therapy with vaginal clindamycin had no significant impact on the incidence of spontaneous preterm delivery prior to 37 completed weeks, OR 0.90, 95% CI 0.40-2.02 (primary outcome variable). However, only 1 of 11 women in the treatment group versus 5 of 12 in the control group delivered prior to 33 completed weeks, OR 0.14, 95% CI 0.02-0.95. Treatment was associated with 32 days longer gestation for the 23 participants who had late miscarriage or spontaneous preterm birth (P= 0.024, Mann-Whitney U test) and significantly fewer infants had a birthweight below 2500 g (secondary outcome). A follow up of infants born preterm 4 years postnatally indicated that extending gestational age did not increase the number of sequelae. Conclusions: Clindamycin vaginal cream therapy was associated with significantly prolonged gestation and reduced cost of neonatal care in women with BV. Early screening for BV and treatment with clindamycin saved approximately €27 per woman. © RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology.
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| 43. |
- Larsson, P-G, et al.
(författare)
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Predisposing factors for bacterial vaginosis, treatment efficacy and pregnancy outcome among term deliveries, results from a preterm delivery study
- 2007
-
Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 7
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Bacterial vaginosis (BV) during pregnancy is associated with an increased risk of preterm delivery but little is known about factors that could predict BV. We have analyzed if it is possible to identify a category of pregnant women that should be screened for BV, and if BV would alter the pregnancy outcome at term, we have also studied the treatment efficacy of clindamycin. Methods: Prospective BV screening and treatment study of 9025 women in a geographically defined region in southeast Sweden. BV was defined as a modified Nugent score of 6 and above. Data was collected from the Swedish Medical Birth Register. Women allocated to treatment were supplied with vaginal clindamycin cream. The main outcome goals were to identify factors that could predict BV. Results: Vaginal smears were consistent with BV criteria in 9.3%. Logistic regression indicates a significant correlation between smoking and BV (p < 0.001) and a greater prevalence of BV in the lower age groups (p < 0.001). We found no correlation between BV and history of preterm deliveries, previous miscarriages, extra-uterine pregnancies, infertility problems or reported history of urinary tract infections-factors that earlier have been associated with BV. Treatment with clindamycin cream showed a cure rate of 77%. Less than 1% of women with a normal vaginal smear in early pregnancy will develop BV during the pregnancy. There was no association between BV and the obstetric outcome among women who delivered at term. Women with BV, both treated patients and nontreated, had the same obstetric outcome at term as women with normal vaginal flora. Conclusion: BV is more than twice as common among smokers, and there is a higher prevalence in the younger age group. However these two markers for BV do not suffice as a tool for screening, and considering the lack of other risk factors associated with BV, screening of all pregnant women might be a strategy to follow in a program intended to reduce the number of preterm births. © 2007 Larsson et al, licensee BioMed Central Ltd.
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| 44. |
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| 45. |
- Liss, Per-Erik, et al.
(författare)
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Terms used to describe urinary tract infections - The importance of conceptual clarification
- 2003
-
Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : Wiley. - 0903-4641 .- 1600-0463. ; 111:2, s. 291-299
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Tidskriftsartikel (refereegranskat)abstract
- Inaccuracies in medical language are detrimental to communication and statistics in medicine, and thereby to clinical practice, medical science and public health. The purpose of this article is to explore inconsistencies in the use of some medical terms: urinary tract infection, bacteriuria and urethral syndrome. The investigated literature was collected from medical dictionaries, textbooks, and articles indexed in Medline«. We found various practices regarding how the medical terms should be defined, and had great difficulty in interpreting the status of the statements under the heading of 'definition'. The lesson to be learned, besides a reminder of the importance of clearly defined medical concepts, is that it must be explicitly stated whether what is presented as a definition is to be considered as defining criterion, as recognising criterion or as characteristic of the disease entity.
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| 46. |
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| 47. |
- Palmqvist, Elisabeth, et al.
(författare)
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Difficulties for primary health care staff in interpreting bacterial findings on a device for simplified urinary culture
- 2008
-
Ingår i: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa UK Limited. - 0036-5513 .- 1502-7686. ; 68:4, s. 312-316
-
Tidskriftsartikel (refereegranskat)abstract
- The reliability of interpretations of findings from dip-slide devices for culturing urine was investigated in a national Swedish external quality assessment (EQA) programme. Also investigated was the extent of improvement in the examination procedure achieved through personnel training programmes and information. According to Swedish national recommendations, dip-slide should only be used in primary health care (PHC) in cases of uncomplicated urinary tract infection (UTI) in females of childbearing age. The recommendations also define six possible outcomes of a dip-slide examination, outcomes that have formed the basis for the EQA programme since 2001. No improvement in ability to classify readings correctly into the six categories was noted for the period 2001 to 2006. Preparations containing 'mixed flora' presented participants with the greatest difficulty, with only 28% correct reports. The EQA programme, with educational components and voluntary participation, has not improved quality. The disappointing results might be a reflection of the limited effort and resources allocated by clinical microbiology laboratories for training and for sustaining proficiency in the evaluation of dip-slides. For these reasons, we cannot at present recommend the dip-slide technique for use in PHC settings. © 2008 Informa UK Ltd (Informa Healthcare, Taylor & Francis AS).
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| 48. |
- Svensson, Erik, 1959-, et al.
(författare)
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Bacteriuria in spinal cord injured patients with neurogenic bladder dysfunction
- 2004
-
Ingår i: Upsala Journal of Medical Sciences. - 0300-9734 .- 2000-1967. ; 109:1, s. 25-32
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Tidskriftsartikel (refereegranskat)abstract
- The occurrence of bacteriuria in spinal cord injured patients with neurogenic bladder dysfunction who used clean intermittent catheterisation to empty their bladders was studied in order to examine cut-off concentration breakpoints for significant bacteriuria in this group of patients using procedures of the European Urinanalysis Guideline. 344 samples were cultured, yielding 285 isolates. Coagulase-negative staphylococci (27 %), Enterococci (25 %), Klebsiella spp (19 %), and Escherichia coli (12 %) were the most common findings. Bacteria grew at concentrations of 105-108 cfu/L, but only a few at 104 cfu/L. It is concluded that low bacterial concentrations in the urine (105 cfu/L) of patients with neurogenic bladder dysfunction who are on intermittent catheterisation might be as significant for bladder contamination with bacteria as a high bacterial concentration and can possibly be responsible for bladder infections.
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| 49. |
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| 50. |
- Westergren, Viveka, 1958-, et al.
(författare)
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Nosocomial sinusitis
- 2005
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Ingår i: Nosocomial sinusitis: a unique subset of sinusitis. - New York : Taylor and Francis. ; , s. 319-356
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- PURPOSE OF REVIEW:Nosocomial sinusitis is a complication of critically ill patients that is frequently not considered as a cause of fever and infection. While this disease has been described in the literature there have been few recent citations on this subject. This brief review will familiarize the reader with the current state of the art with regard to diagnosis complications and treatment of this problem.RECENT FINDINGS:Nasal and oral tubes have been the prime inciting events. Other risk factors have been facial trauma, inability to mobilize the patient and prior sinus disease. Patients usually present while in the intensive care unit; and there are few signs that suggest sinusitis to the critical care team. A number of complications including direct extension to the brain, lung and blood stream, as well as sepsis and even death have been described. The diagnosis is usually made with the help of specific radiographs or computed tomography scans when these modalities are used. The microbiology is quite different than sinusitis in the community. Staphylococcus spp., Pseudomonas spp. and other nosocomial organisms are frequently isolated when specific cultures are obtained. Treatment usually consists of removal of the tubes mobilizing the patient and institution of broad-spectrum antibiotics aimed at the offending organisms.SUMMARY:Nosocomial sinusitis continues to be a major problem causing morbidity and occasionally mortality in critically ill patients. Recent findings have suggested that a careful search for this disease and appropriate treatment if found can decrease both morbidity, mortality and subsequent other nosocomial infections
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